Document Detail


Site of positive surgical margins influences biochemical recurrence after radical prostatectomy.
MedLine Citation:
PMID:  19549257     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether the number and location of positive surgical margins (PSMs) in radical prostatectomy (RP) surgical specimens affect biochemical recurrence (BCR) rates. PATIENTS AND METHODS: The locations of PSMs were recorded for 1308 consecutive men who underwent RP between October 2000 and December 2006. BCR was defined as three consecutive prostate-specific antigen (PSA) level rises with the peak level >or=0.15 ng/mL. Multivariate regression analyses were used to identify preoperative predictors of PSMs and BCR. The estimated 5-year risk of BCR was calculated using the Kaplan-Meier method. RESULTS: In all, 128 (9.8%) men had one or more PSMs. The mean body mass index, mean preoperative serum PSA level, the distributions of clinical stage and biopsy Gleason scores, and the presence or absence of biopsy perineural invasion were significantly different between men with or with no PSMs. In multivariate analysis, baseline serum PSA level, Gleason score and perineural invasion were independent preoperative predictors of PSMs. The 5-year actuarial BCR rates were dependent on the site of the PSM (P = 0.035) and not the number of PSMs (P = 0.18). The rank order of estimated 5-year BCR rates according to the site of PSMs were base > anterior > posterolateral > apex approximately posterior. CONCLUSIONS: About half of the men with PSMs in the RP surgical specimen in our prospective series did not develop BCR. The risk of BCR was dependent on the site and not the number of PSMs. Adjuvant therapy should be considered in cases with anterior and basilar PSMs due to the very high risk of BCR.
Authors:
Guilherme Godoy; Basir U Tareen; Herbert Lepor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-22
Journal Detail:
Title:  BJU international     Volume:  104     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-01-07     Completed Date:  2010-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1610-4     Citation Subset:  IM    
Affiliation:
Division of Urologic Oncology, Department of Urology, New York University School of Medicine, New York, NY 10016, USA.
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MeSH Terms
Descriptor/Qualifier:
Epidemiologic Methods
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / blood,  pathology*
Neoplasm, Residual
Prognosis
Prostate / pathology*,  surgery
Prostate-Specific Antigen / blood*
Prostatectomy / methods*
Prostatic Neoplasms / blood,  pathology*,  surgery
Chemical
Reg. No./Substance:
EC 3.4.21.77/Prostate-Specific Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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